| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,032 |
1,015 |
$33K |
| 92250 |
|
466 |
442 |
$19K |
| V2020 |
Frames, purchases |
1,239 |
1,216 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
883 |
446 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
227 |
222 |
$12K |
| 92285 |
|
465 |
443 |
$11K |
| 92081 |
|
161 |
156 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
336 |
167 |
$5K |
| 92082 |
|
70 |
68 |
$2K |
| 76512 |
|
15 |
15 |
$970.38 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$305.24 |
| 76514 |
|
46 |
46 |
$95.88 |
| 92025 |
|
72 |
70 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
304 |
150 |
$0.00 |
| 92286 |
|
57 |
57 |
$0.00 |